Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths among American Indian and Alaska Native (AI/AN) populations. Further, AI/ANs are twice as likely to be diagnosed with advanced rather than localized CRC compared to non-Hispanic Whites, suggesting that lack of access to adequate cancer screening and treatment may play a role. Yet, few studies have tested culturally appropriate interventions to increase CRC screening among AI/ANs. Our research team has developed and tested a novel intervention package to promote CRC screening in an urban and underserved Asian minority population. This intervention, which involved a health educator, a culturally-tailored video, and a pamphlet, was remarkably successful: 70% of the intervention group were screened compared to 28% of the control group. The goal of the proposed study Is to culturally adapt this successful CRC screening intervention with AI/AN patients. We will modify the media for conveying the screening intervention by using digital stories, a new media methodology that capitalizes on the tradition of Native storytelling. The CRC screening intervention will be implemented in partnership with the only 2 urban clinics in Washington State that serve the AI/AN population: the Seattle Indian Health Board and NATIVE Health of Spokane. Our specific aims are to: 1) Estimate the effectiveness of digital stories accompanied by an educational pamphlet to improve CRC screening rates in AI/ANs;2) Using qualitative methods, examine the adoption, implementation, and maintenance of our CRC screening intervention at these 2 urban Indian clinics. Today, over 55% of AI/ANs live in urban areas, yet urban AI/AN people have been called the "invisible minority." Because neither the Indian Health Service nor the National Center for Health Statistics systematically collects information on this group, the needs of AI/ANs living off reservation lands are rarely recognized and they are under-represented in research. To our knowledge, this will be the first CRC screening intervention targeting urban AI/ANs.